A Case of Iliac Compression Syndrome Successfully Treated with Catheter-Directed Thrombolysis: Application of Diagnostic MRI Methods for Phase–Assessment of Venous Thromboses

A 20–year–old male with pulmonary embolism and deep venous thrombosis due to iliac compression syndrome was successfully treated with anticoagulation and catheter–directed thrombolysis (CDT). We applied a diagnostic magnetic resonance imaging method for thrombus–age assessment. In the acute phase, black blood T2–weighted (BBT2W) imaging showed very low signal intensity (SI) of the venous thrombus. However, in the subacute phase, SI was extremely high, and two months after the onset (chronic phase), BBT2W imaging showed medium SI. Thrombus–age information is essential for successful CDT. Our observations allow clinicians to distinguish between acute, subacute and chronic thromboses, allowing optimal application of CDT.